Statistics

Kelvin Hill · Steven McGloughlin · Sharon McGowan · Tari Turner

Mike Starr

Almost five years into the COVID-19 pandemic, there are still major gaps in our knowledge as to the pathophysiology, treatment and prognosis of long COVID

David A Watters · Lance Emerson

Improved community understanding of long COVID is required, and health systems need to develop clear pathways for treating patients, especially for those with persistent impairment

Alex Holmes · Lance Emerson · Louis B Irving · Emma Tippett · Jeffrey M Pullin · Julie Young · David A Watters · Adina Hamilton

Identification of predisposing risk factors is essential to inform early intervention and management strategies for patients at greatest risk of long COVID

Abbish Kamalakkannan · Mirela Prgomet · Judith Thomas · Christopher Pearce · Precious McGuire · Fiona Mackintosh · Andrew Georgiou

Understanding how to deliver holistic supervision and support for the challenges doctors face when training as general practitioners in rural, remote and First Nations communities, can support interventions which build personal and professional resilience for rural practice

Belinda G O'Sullivan · Patrick Giddings · Ronda Gurney · Matthew R McGrail · Tiana Gurney

The RVTS model of training doctors continuously in the same practice improves access to safe and high quality longitudinal care and contributes to service enhancements in rural, remote and First Nations communities that otherwise lack stable doctors

Belinda G O'Sullivan · Patrick Giddings · Matthew R McGrail

Alain Braillon

Meeting demand for higher care level support will require a larger aged care workforce particularly in regional and remote areas

Johannes Schwabe · Gillian E Caughey · Steve L Wesselingh · Craig Whitehead · Renuka Visvanathan · Keith Evans · Maria C Inacio

The health and economic burdens of long COVID are substantial, especially for working adults

Valentina Costantino · Quentin Grafton · Tom Kompas · Long Chu · Damian Honeyman · Adriana Notaras · C Raina MacIntyre

To the Editor: Holland and colleagues reported on the Alfred Health post‐COVID‐19 service experience with the health of patients who had previously been hospitalised, or managed in a hospital‐in‐the‐home setting, with COVID‐19.1 Participants responded to an invitation to register for follow‐up, and then completed a questionnaire. The study also included a separate group (13% of the cohort) who were not necessarily admitted to Alfred Health but lived in the Alfred Health catchment — and might have been managed as outpatients or inpatients in another service but were referred by their local doctors to a specialist clinic targeted for patients with symptoms after initial COVID‐19, and subsequently completed the questionnaire. Sixty per cent of respondents had at least one persistent symptom at eight weeks. The study reported apparently high prevalences of other symptoms, such as post‐traumatic stress disorder in 23%. These results are derived from their cohort and may not be generally applicable. The authors caution: “We could not distinguish between new symptoms and those attributable to other health conditions. Our study did not include a contemporary control group”.1 More importantly, there was no control group of patients hospitalised from non‐COVID‐19 viral illness (with sufficient severe illness to lead to almost 5% spending time in an intensive care unit), who were then concentrated by an invitation, and then sufficiently motivated to fill out a questionnaire. Plausibly in such a group, at eight weeks, 60% would report at least one persistent symptom. Interpretation of their results is also obscured by the patients referred from the community, who came from a bigger population of patients with COVID‐19 concentrated to include only those who sought or agreed to a referral to a specialist follow‐up clinic. The authors wisely identified weaknesses and they should be applauded for their review of their experience. More definitive conclusions about higher rates of persisting ill health caused by COVID‐19 (in comparison to similarly severe infectious illness) might be achieved if they can follow this up — as they perhaps recognise — with a prospective analytic design in a cohort of patients presenting with similar severity of viral illness comparing those with and without COVID‐19 over the long term.

Jeremy L Millar

Aboriginal and Torres Strait Islander communities remain invisible in data which is used to inform policy, clinical models of care, health services and initiatives

Courtney Ryder · Sadia Hossain · Leanne Howard · Julia Severin · Rebecca Ivers

In view of the projected increase in disease burden, further research into prevention and early detection is needed

Qingwei Luo · Deanne Jenkin · Marianne F Weber · Julia Steinberg · Kate White · Adam Irving · Hannah Rillstone · Anna Kelly · Karen Canfell · Eleonora Feletto